Birth Control Pills/Oral Contraceptives

Combination birth control pills – contain both estrogen and progesterone hormones and prevent your ovaries from releasing an egg/ovulation. They also cause changes in the cervical mucus and the lining of the uterus to keep sperm from joining the egg. Although the type of estrogen is the same in most pills, the doses may differ. There are a number of different progestins and those doses may also differ. Continuous-dosing or extended-cycle pills allow you to reduce the number of periods you have each year.

Continuous dosing – Active hormone is taken beyond the typical 21 days. Most women take a placebo (sugar pill) for 7 days every 3 months to as long as a year, and is followed by bleeding. Bleeding generally occurs during the seven days you take the inactive pills. This option is used in women who prefer to have fewer periods but can also be used to treat medical issues such as excessive bleeding related to uterine fibroids, prevention of menstrual migraines, relief from pain related to endometriosis.

Who should NOT be on combination birth control pill:

  • If you are in the first month of breast-feeding
  • If you are older than 35 and smoke
  • If you have poorly controlled high blood pressure
  • If you have a history of deep vein thrombosis or pulmonary embolism
  • If you have a history of stroke or heart disease
  • If you have a history of breast cancer
  • If you have migraines with aura
  • If you have diabetes-related complications, such as nephropathy, retinopathy or neuropathy
  • If you have liver disease
  • If you have unexplained uterine bleeding
  • If you will be immobilized for a prolonged period due to major surgery


  • Reliable and easily reversed
  • Fertility can return to normal almost immediately after stopping the pills.
  • Reduced risk of ovarian and endometrial (uterine) cancers
  • Reduced risk of ectopic pregnancy
  • Reduced risk of ovarian cysts
  • Improvement in acne
  • Improvement of menstrual cramps (dysmenorrhea)
  • Reduction in androgen (male hormones) production caused by polycystic ovary syndrome
  • Shorter, lighter and more-predictable periods or, for some types of pills, fewer periods yearly
  • Reduction in related iron-deficiency anemia
  • Relief from premenstrual syndrome (PMS)
  • Reduction in hot flashes for women nearing menopause (perimenopause)

Risks and side effects:

  • Pregnancy – An estimated 9 out of 100 women taking combination birth control pills will get pregnant in the first year of use. With perfect use, the pregnancy rate is less than 1 in 100 women every year.
  • The pill will not protect you from sexually transmitted infections.
  • Breakthrough bleeding or spotting more common with continuous-dosing or extended-cycle pills
  • Breast tenderness
  • Elevated blood pressure
  • Headaches
  • Nausea
  • Bloating
  • Some side effects — including nausea, headaches, breast tenderness and breakthrough bleeding — might decrease with continued use.

Rare but potentially serious risks:

  • Blood clots in the legs
  • Heart attacks and stroke, especially if you smoke
  • Liver disorders
  • Gallbladder disease

Please see Dr. Fleming in her Wellesley, MA office near Boston, MA for consultation to determine what contraception will be best for you based on your concerns and preferences, as well as your medical history. She will check your blood pressure, your weight and review your medical history and medications you’re taking and together will choose a method that is best for you.

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    Office Hours:

    9:00AM – 5:00PM


    Conveniently located at Playhouse Square at the corner of Forest Street and Washington Street in Wellesley, MA.